Is the House Health Care Bill Better Than Nothing?

Is the House Health Care Bill Better Than Nothing?

Unless you investigate well-past the mainstream media, you can be forgiven for knowing very little if anything about what’s actually in the health care reform bill passed by the House of Representatives last weekend.

Is it “historic,” as Democratic House leaders say, or a “government takeover,” as Republicans and their teabagger allies allege? Or is it possibly neither – or something else all together?

While the post-vote debate this past week has been consumed almost entirely by the anti-choice Stupak amendment, an addition of massive significance that might sink the whole health care reform effort by itself, the more fundamental question remains: even if the amendment wasn’t there, does the House bill deserve our support? Meaning, will it actually do anything to improve our disastrously dysfunctional health care system?

It’s hard to get a more authoritative or respected opinion than that of Dr. Marcia Angel, senior lecturer at Harvard Medical School and former editor of the prestigious New England Journal of Medicine. As Dr. Angel points out in her article, “Is the House Health Care Bill Better Than Nothing?”:

* The “public option” in the bill is not really an “option” at all, but a program projected to cover only 6 million uninsured Americans.

* The House bill’s “individual mandate” forces every American to buy health insurance, thus delivering tens of millions of new and unwilling customers to the insurance industry. (Interestingly, former President Bill Clinton, who is now campaigning for this bill, considered the individual mandate an evil Republican idea when he was trying to get a health care bill passed in the 1990s.)

* The bill contains no cost control provisions, and would allow the insurance industry to raise premiums as it sees fit.

* The bill would pump billions of public taxpayer dollars into the coffers of the insurance industry, whether in the form of taxpayer subsidies to individuals to buy health insurance or the money that would be cut from Medicare and redirected to the private sector.

Even some of the best sounding provisions, such as the regulation outlawing denial of benefits due to “pre-existing conditions,” have potentially giant loopholes. If the bill does not specifically mandate that insurance companies cover all medically-approved treatment, do we really believe the companies won’t find some other excuse to deny coverage – or simply increase their premiums to cover the added expense?

To read Dr. Angel’s column “Is the House Health Care Bill Better Than Nothing?,” which includes here five point program for real reform, click here.

Some have protested Dr. Angel’s title, noting that under the bill 36 million more Americans (about 2/3 of the currently uninsured) would get some kind of insurance, and the bill would at least reduce the approximately 40,000 annual deaths which result from lack of insurance. Certainly that sounds “better than nothing.”

Yet at the same time, the bill would augment and enshrine the central role of the investor-owned insurance industry, which is in fact the single biggest problem in our health care system, and it would throw hundreds of billions more into a dysfunctional and fundamentally unsustainable system. More people would have insurance, but it will likely cost more and cover less.

Once again, those of us who care about universal health care are asked to make an excruciating choice to support this bill. (As opposed to the insurance companies, who make out like bandits either way.)

The argument for accepting this bill – and remember, it will only get weaker/worse as it makes its way through the Senate – is that you can take what you can get now, and then build on that in the future. Yet what examples are there of major government programs of social change being dramatically improved or expanded after passage, as opposed to being constantly attacked and whittled away?

And if the Democratic Party leadership is unwilling to fight for or even discuss a truly progressive health care system (single payer) – even at this moment when they control the White House and both houses of Congress with a filibuster-proof majority in the Senate – what are the chances they are going to come back and try to do better the next time around?